Airway involvement in pulmonary tuberculosis

Lymph gland involvement of the airways is common in young children with pulmonary tuberculosis. This lymph gland involvement leads to lymphobronchial tuberculosis, which presents with varying degrees of airway obstruction. These children are best assessed by fibreoptic bronchoscopy and are treated with the normal anti-tuberculosis regimens to which corticosteroids are added for a month and then weaned off over the next month. If, after a month, the children remain symptomatic, they must be re-evaluated by bronchoscopy and chest computed tomography. Surgery must be considered in children with severe airway obstruction still present at the time of the second evaluation. Surgical intervention consists of endoscopic or transthoracic enucleation of the lymph nodes. Only a small percentage of those with lymphobronchial tuberculosis will require surgery to relieve their airway obstruction. (c) 2007 Elsevier Ltd. All rights reserved.